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25 U.S.C. § 1647 — Grants to and contracts with the Service, Indian tribes, tribal organizations, and urban Indian organizations to facilitate outreach, enrollment, and coverage of Indians under Social Security Act health benefit programs and other health benefits programs
Federal law — U.S. Code and appendices · legal_authorities
**(a) Indian tribes and tribal organizations** The Secretary, acting through the Service, shall make grants to or enter into contracts with Indian tribes and tribal organizations to assist such tribes and tribal organizations in establishing and administering programs on or near reservations and trust lands, including programs to provide outreach and enrollment through video, electronic delivery methods, or telecommunication devices that allow real-time or time-delayed communication between individual Indians and the benefit program, to assist individual Indians—
(1) to enroll for benefits under a program established under title XVIII, XIX, or XXI of the Social Security Act [[42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq., 1396 et seq., 1397aa et seq.] and other health benefits programs; and
(2) with respect to such programs for which the charging of premiums and cost sharing is not prohibited under such programs, to pay premiums or cost sharing for coverage for such benefits, which may be based on financial need (as determined by the Indian tribe or tribes or tribal organizations being served based on a schedule of income levels developed or implemented by such tribe, tribes, or tribal organizations).
**(b) Conditions** The Secretary, acting through the Service, shall place conditions as deemed necessary to effect the purpose of this section in any grant or contract which the Secretary makes with any Indian tribe or tribal organization pursuant to this section. Such conditions shall include requirements that the Indian tribe or tribal organization successfully undertake—
(1) to determine the population of Indians eligible for the benefits described in subsection (a);
(2) to educate Ind
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**(a) Indian tribes and tribal organizations** The Secretary, acting through the Service, shall make grants to or enter into contracts with Indian tribes and tribal organizations to assist such tribes and tribal organizations in establishing and administering programs on or near reservations and trust lands, including programs to provide outreach and enrollment through video, electronic delivery methods, or telecommunication devices that allow real-time or time-delayed communication between individual Indians and the benefit program, to assist individual Indians—
(1) to enroll for benefits under a program established under title XVIII, XIX, or XXI of the Social Security Act [[42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq., 1396 et seq., 1397aa et seq.] and other health benefits programs; and
(2) with respect to such programs for which the charging of premiums and cost sharing is not prohibited under such programs, to pay premiums or cost sharing for coverage for such benefits, which may be based on financial need (as determined by the Indian tribe or tribes or tribal organizations being served based on a schedule of income levels developed or implemented by such tribe, tribes, or tribal organizations).
**(b) Conditions** The Secretary, acting through the Service, shall place conditions as deemed necessary to effect the purpose of this section in any grant or contract which the Secretary makes with any Indian tribe or tribal organization pursuant to this section. Such conditions shall include requirements that the Indian tribe or tribal organization successfully undertake—
(1) to determine the population of Indians eligible for the benefits described in subsection (a);
(2) to educate Indians with respect to the benefits available under the respective programs;
(3) to provide transportation for such individual Indians to the appropriate offices for enrollment or applications for such benefits; and
(4) to develop and implement methods of improving the participation of Indians in receiving benefits under such programs.
**(c) Application to urban Indian organizations**
(1) **In general** — The provisions of subsection (a) shall apply with respect to grants and other funding to urban Indian organizations with respect to populations served by such organizations in the same manner they apply to grants and contracts with Indian tribes and tribal organizations with respect to programs on or near reservations.
(2) **Requirements** — The Secretary shall include in the grants or contracts made or provided under paragraph (1) requirements that are—
(A) consistent with the requirements imposed by the Secretary under subsection (b);
(B) appropriate to urban Indian organizations and urban Indians; and
(C) necessary to effect the purposes of this section.
**(d) Facilitating cooperation** The Secretary, acting through the Centers for Medicare & Medicaid Services, shall develop and disseminate best practices that will serve to facilitate cooperation with, and agreements between, States and the Service, Indian tribes, tribal organizations, or urban Indian organizations with respect to the provision of health care items and services to Indians under the programs established under title XVIII, XIX, or XXI of the Social Security Act [[42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq., 1396 et seq., 1397aa et seq.].
**(e) Agreements relating to improving enrollment of Indians under Social Security Act health benefits programs** For provisions relating to agreements of the Secretary, acting through the Service, for the collection, preparation, and submission of applications by Indians for assistance under the Medicaid and children’s health insurance programs established under titles XIX and XXI of the Social Security Act [[42 U.S.C. 1396](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396&num=0&edition=prelim) et seq., 1397aa et seq.], and benefits under the Medicare program established under title XVIII of such Act [[42 U.S.C. 1395](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395&num=0&edition=prelim) et seq.], see subsections (a) and (b) of section 1139 of the Social Security Act [[42 U.S.C. 1320b–9](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320b–9&num=0&edition=prelim)].
**(f) Definition of premiums and cost sharing** In this section:
(1) **Premium** — The term “premium” includes any enrollment fee or similar charge.
(2) **Cost sharing** — The term “cost sharing” includes any deduction, deductible, copayment, coinsurance, or similar charge.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Establishment** There is hereby established the Medicaid and CHIP Payment and Access Commission (in this section referred to as “MACPAC”).
**(b) Duties**
(1) **Review of access policies for all States and annual reports** — MACPAC shall—
(A) review policies of the Medicaid program established under this subchapter (in this section referred to as “Medicaid”) and the State Children’s Health Insurance Program established under subchapter XXI (in this section referred to as “CHIP”) affecting access to covered items and services, including topics described in paragraph (2);
(B) make recommendations to Congress, the Secretary, and States concerning such access policies;
(C) by not later than March 15 of each year (beginning with 2010), submit a report to Congress containing the results of such reviews and MACPAC’s recommendations concerning such policies; and
(D) by not later than June 15 of each year (beginning with 2010), submit a report to Congress containing an examination of issues affecting Medicaid and CHIP, including the implications of changes in health care delivery in the United States and in the market for health care services on such programs.
(2) **Specific topics to be reviewed** — Specifically, MACPAC shall review and assess the following:
(A) *Medicaid and CHIP payment policies* — Payment policies under Medicaid and CHIP, including—
(i) the factors affecting expenditures for the efficient provision of items and services in different sectors, including the process for updating payments to medical, dental, and health professionals, hospitals, residential and long-term care providers, providers of home and community based services, Federally-qualified health centers and rural health clinics, managed care entities, and providers of ot
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Federal law — U.S. Code and appendices · legal_authorities
### Statutory Notes
Section, Pub. L. 94–437, title II, § 224, as added Pub. L. 102–573, title II, § 217(a), Oct. 29, 1992, 106 Stat. 4559, authorized appropriations to carry out this subchapter through fiscal year 2000.
The repeal is based on section 101(b)(5) of title I of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Agreements with States for Medicaid and CHIP outreach on or near reservations to increase the enrollment of Indians in those programs**
(1) **In general** — In order to improve the access of Indians residing on or near a reservation to obtain benefits under the Medicaid and State children’s health insurance programs established under subchapters XIX and XXI, the Secretary shall encourage the State to take steps to provide for enrollment on or near the reservation. Such steps may include outreach efforts such as the outstationing of eligibility workers, entering into agreements with the Indian Health Service, Indian Tribes, Tribal Organizations, and Urban Indian Organizations to provide outreach, education regarding eligibility and benefits, enrollment, and translation services when such services are appropriate.
(2) **Construction** — Nothing in paragraph (1) shall be construed as affecting arrangements entered into between States and the Indian Health Service, Indian Tribes, Tribal Organizations, or Urban Indian Organizations for such Service, Tribes, or Organizations to conduct administrative activities under such subchapters.
**(b) Requirement to facilitate cooperation** The Secretary, acting through the Centers for Medicare & Medicaid Services, shall take such steps as are necessary to facilitate cooperation with, and agreements between, States and the Indian Health Service, Indian Tribes, Tribal Organizations, or Urban Indian Organizations with respect to the provision of health care items and services to Indians under the programs established under subchapter XIX or XXI.
**(c) Definition of Indian; Indian Tribe; Indian Health Program; Tribal Organization; Urban Indian Organization** For purposes of this section, subchapter XIX, and subchapter XXI, the te
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Federal law — U.S. Code and appendices · legal_authorities
This chapter may be cited as the “Social Security Act”.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Conditions of participation; protection of individual rights; notification of State entities; use of home health aides; medical equipment; individual’s plan of care; compliance with Federal, State, and local laws and regulations** The conditions of participation that a home health agency is required to meet under this subsection are as follows:
(1) The agency protects and promotes the rights of each individual under its care, including each of the following rights:
(A) The right to be fully informed in advance about the care and treatment to be provided by the agency, to be fully informed in advance of any changes in the care or treatment to be provided by the agency that may affect the individual’s well-being, and (except with respect to an individual adjudged incompetent) to participate in planning care and treatment or changes in care or treatment.
(B) The right to voice grievances with respect to treatment or care that is (or fails to be) furnished without discrimination or reprisal for voicing grievances.
(C) The right to confidentiality of the clinical records described in section 1395x(o)(3) of this title.
(D) The right to have one’s property treated with respect.
(E) The right to be fully informed orally and in writing (in advance of coming under the care of the agency) of—
(i) all items and services furnished by (or under arrangements with) the agency for which payment may be made under this subchapter,
(ii) the coverage available for such items and services under this subchapter, subchapter XIX, and any other Federal program of which the agency is reasonably aware,
(iii) any charges for items and services not covered under this subchapter and any charges the individual may have to pay with respect to items and services furn
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Federal law — U.S. Code and appendices · legal_authorities
Page 307
TITLE 25—INDIANS
§ 1647a
1 See References in Text note below.
ter. For complete classification of this Act to the Code,
see Short Title note set out under section 1601 of this
title and Tables.
§ 1647. Eligible Indian veteran services
(a) Findings; purpose
(1) Findings
Congress finds that—
(A) collaborations between the Secretary
and the Secretary of Veterans Affairs re-
garding the treatment of Indian veterans at
facilities of the Service should be encour-
aged to the maximum extent practicable;
and
(B) increased enrollment for services of the
Department of Veterans Affairs by veterans
who are members of Indian tribes should be
encouraged to the maximum extent prac-
ticable.
(2) Purpose
The purpose of this section is to reaffirm the
goals stated in the document entitled ‘‘Memo-
randum of Understanding Between the VA/
Veterans Health Administration And HHS/In-
dian Health Service’’ and dated February 25,
2003 (relating to cooperation and resource
sharing between the Veterans Health Adminis-
tration and Service).
(b) Definitions
In this section:
(1) Eligible Indian veteran
The term ‘‘eligible Indian veteran’’ means
an Indian or Alaska Native veteran who re-
ceives any medical service that is—
(A) authorized under the laws adminis-
tered by the Secretary of Veterans Affairs;
and
(B) administered at a facility of the Serv-
ice (including a facility operated by an In-
dian tribe or tribal organization through a
contract or compact with the Service under
the Indian Self-Determination and Edu-
cation Assistance Act (25 U.S.C. 450 et seq.)) 1
pursuant to a local memorandum of under-
standing.
(2) Local memorandum of understanding
The term ‘‘local memorandum of under-
standing’’ means a memorandum of under-
standing between the Secretary
Source: Supplied 2024 U.S. Code historical extraction · 25 U.S.C. § 1647
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Federal law — U.S. Code and appendices · legal_authorities
### Statutory Notes
Section, act Aug. 14, 1935, ch. 531, title XI, § 1130, as added Oct. 20, 1972, Pub. L. 92–512, title III, § 301(a), 86 Stat. 945; amended July 9, 1973, Pub. L. 93–66, title II, § 221, 87 Stat. 159; Dec. 31, 1973, Pub. L. 93–233, § 18(j), 87 Stat. 970, set out limitations on funds for certain social services.
#### Effective Date of Repeal
Repeal effective with respect to payments under sections 603 and 803 of this title for quarters commencing after Sept. 30, 1975, see section 7(b) of Pub. L. 93–647, set out as an Effective Date of 1975 Amendment note under [section 303 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section303&num=0&edition=prelim).
#### Social Services Regulations Postponed
Pub. L. 93–233, § 12, Dec. 31, 1973, 87 Stat. 959, as amended by Pub. L. 93–647, § 3(g), Jan. 4, 1975, 88 Stat. 2349, provided that: “(a) Subject to subsection (b), no regulation and no modification of any regulation, promulgated by the Secretary of Health, Education, and Welfare [now Health and Human Services] (hereinafter referred to as the ‘Secretary’) after January 1, 1973, shall be effective for any period which begins prior to October 1, 1975, if (and insofar as) such regulation or modification of a regulation pertains (directly or indirectly) to the provisions of law contained in section 3(a)(4)(A), 402(a)(19)(G), 403(a)(3)(A), 603(a)(1)(A), 1003(a)(3)(A), 1403(a)(3)(A), or 1603(a)(4)(A) of the Social Security Act [section 303(a)(4)(A), 602(a)(19)(G), 603(a)(3)(A), 803(a)(1)(A), 1203(a)(3)(A), 1353(a)(3)(A), or 1383(a)(4)(A) of this title]. “(b)(1) The provisions of subsection (a) shall not be applicable to any regulation relating to ‘scope of programs’, if such regulation is identical (except as provided in the succe
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1320b
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Federal law — U.S. Code and appendices · legal_authorities
Page 2672
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 1320b
tended to alter the holding in Suter v. Artist M.
that section 671(a)(15) of this title is not enforce-
able in a private right of action.
(Aug. 14, 1935, ch. 531, title XI, § 1130A, as added
Pub. L. 103–432, title II, § 211(a), Oct. 31, 1994, 108
Stat. 4460.)
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE
Pub. L. 103–432, title II, § 211(b), Oct. 31, 1994, 108 Stat.
4460, provided that: ‘‘The amendment made by sub-
section (a) [enacting this section] shall apply to actions
pending on the date of the enactment of this Act [Oct.
31, 1994] and to actions brought on or after such date of
enactment.’’
§ 1320b. Repealed. Pub. L. 93–647, § 3(e)(1), Jan. 4,
1975, 88 Stat. 2349
Section, act Aug. 14, 1935, ch. 531, title XI, § 1130, as
added Oct. 20, 1972, Pub. L. 92–512, title III, § 301(a), 86
Stat. 945; amended July 9, 1973, Pub. L. 93–66, title II,
§ 221, 87 Stat. 159; Dec. 31, 1973, Pub. L. 93–233, § 18(j), 87
Stat. 970, set out limitations on funds for certain social
services.
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE OF REPEAL
Repeal effective with respect to payments under sec-
tions 603 and 803 of this title for quarters commencing
after Sept. 30, 1975, see section 7(b) of Pub. L. 93–647, set
out as an Effective Date of 1975 Amendment note under
section 303 of this title.
SOCIAL SERVICES REGULATIONS POSTPONED
Pub. L. 93–233, § 12, Dec. 31, 1973, 87 Stat. 959, as
amended by Pub. L. 93–647, § 3(g), Jan. 4, 1975, 88 Stat.
2349, provided that:
‘‘(a) Subject to subsection (b), no regulation and no
modification of any regulation, promulgated by the
Secretary of Health, Education, and Welfare [now
Health and Human Services] (hereinafter referred to as
the ‘Secretary’)
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1320b
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Federal law — U.S. Code and appendices · legal_authorities
Page 2893
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 1395a
(i) shared savings and competitive bidding in FFS
Medicare;
(ii) use of MA-negotiated rates to set FFS Medicare
rates; and
(iii) novel approaches to information development
and sharing that may enable markets to lower cost and
improve quality for FFS Medicare beneficiaries.
SEC. 10. Reducing Obstacles to Improved Patient Care.
Within 1 year of the date of this order, the Secretary
shall propose regulatory changes to the Medicare pro-
gram to reduce the burden on providers and eliminate
regulations that create inefficiencies or otherwise un-
dermine patient outcomes.
SEC. 11. Maximizing Freedom for Medicare Patients and
Providers. (a) Within 180 days of the date of this order,
the Secretary, in coordination with the Commissioner
of Social Security, shall revise current rules or policies
to preserve the Social Security retirement insurance
benefits of seniors who choose not to receive benefits
under Medicare Part A, and propose other administra-
tive improvements to Medicare enrollment processes
for beneficiaries.
(b) Within 1 year of the date of this order, the Sec-
retary shall identify and remove unnecessary barriers
to private contracts that allow Medicare beneficiaries
to obtain the care of their choice and facilitate the de-
velopment of market-driven prices.
SEC. 12. General Provisions. (a) Nothing in this order
shall be construed to impair or otherwise affect:
(i) the authority granted by law to an executive de-
partment or agency, or the head thereof; or
(ii) the functions of the Director of the Office of Man-
agement and Budget relating to budgetary, administra-
tive, or legislative proposals.
(b) This order shall be implemented consistent with
applicable law and subject to the
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1395
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Federal law — U.S. Code and appendices · legal_authorities
Page 4009
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 1396
of the enactment of this Act [Oct. 6, 2014], the Sec-
retary shall develop and report to Congress on a stra-
tegic plan for collecting or otherwise accessing data on
race and ethnicity for purposes of specifying quality
measures and resource use and other measures under
subsections (c) and (d) of section 1899B of the Social Se-
curity Act, as added by subsection (a), and, as the Sec-
retary determines appropriate, other similar provisions
of, including payment adjustments under, title XVIII of
such Act (42 U.S.C. 1395 et seq.).’’
SUBCHAPTER XIX—GRANTS TO STATES
FOR MEDICAL ASSISTANCE PROGRAMS
§ 1396. Medicaid and CHIP Payment and Access
Commission
(a) Establishment
There is hereby established the Medicaid and
CHIP Payment and Access Commission (in this
section referred to as ‘‘MACPAC’’).
(b) Duties
(1) Review of access policies for all States and
annual reports
MACPAC shall—
(A) review policies of the Medicaid pro-
gram established under this subchapter (in
this section referred to as ‘‘Medicaid’’) and
the State Children’s Health Insurance Pro-
gram established under subchapter XXI (in
this section referred to as ‘‘CHIP’’) affecting
access to covered items and services, includ-
ing topics described in paragraph (2);
(B) make recommendations to Congress,
the Secretary, and States concerning such
access policies;
(C) by not later than March 15 of each year
(beginning with 2010), submit a report to
Congress containing the results of such re-
views and MACPAC’s recommendations con-
cerning such policies; and
(D) by not later than June 15 of each year
(beginning with 2010), submit a report to
Congress
containing
an
examination
of
issues affecting Medicaid and CHIP, includ-
ing the impli
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1396
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